SJT FINAL

Question 1

Serena is a dental student who is shadowing a senior dentist, Mr Wardett. Mr Wardett is replacing a filling for a patient using a brand-new tool. The tool is different to the one Serena conducted her training on at university. A few days later, another patient requires a filling replacement and Mr Wardett asks Serena to conduct the procedure while he supervises. She is not confident in her ability to use the new tool.

How important to take into account are the following considerations for Serena when deciding how to respond to the situation?

That the new tool may be more effective?

Answer 1

very important

Question 2

Serena is a dental student who is shadowing a senior dentist, Mr Wardett. Mr Wardett is replacing a filling for a patient using a brand-new tool. The tool is different to the one Serena conducted her training on at university. A few days later, another patient requires a filling replacement and Mr Wardett asks Serena to conduct the procedure while he supervises. She is not confident in her ability to use the new tool.

How important to take into account are the following considerations for Serena when deciding how to respond to the situation?

That Mr Wardett may not give her other learning opportunities if he finds out that she is not familiar with using the latest tools

Answer 2

Minor importance

Question 3

Serena is a dental student who is shadowing a senior dentist, Mr Wardett. Mr Wardett is replacing a filling for a patient using a brand-new tool. The tool is different to the one Serena conducted her training on at university. A few days later, another patient requires a filling replacement and Mr Wardett asks Serena to conduct the procedure while he supervises. She is not confident in her ability to use the new tool.

How important to take into account are the following considerations for Serena when deciding how to respond to the situation?

That she is a student so will not be expected to know everything

Answer 3

Very important

Question 4

Sapphire has been asked to do a group presentation on sleep disorders as part of her course. In a meeting earlier in the week, she and her partner, Dominik, agreed that they would evenly distribute the work and would each present the sections that they wrote. The presentation is in an hour and Sapphire and Dominik are practising when Dominik begins to panic and tells Sapphire that he does not think he can present his sections as he is too nervous. He asks Sapphire to present his sections for him.

How important to take into account are the following considerations for Sapphire when deciding how to respond to the situation?

Her own confidence in presenting Dominik’s slides

Answer 4

Very important. Medical and dental professionals do not operate outside the scope of their practice and competence

Question 5

Sapphire has been asked to do a group presentation on sleep disorders as part of her course. In a meeting earlier in the week, she and her partner, Dominik, agreed that they would evenly distribute the work and would each present the sections that they wrote. The presentation is in an hour and Sapphire and Dominik are practising when Dominik begins to panic and tells Sapphire that he does not think he can present his sections as he is too nervous. He asks Sapphire to present his sections for him.

How important to take into account are the following considerations for Sapphire when deciding how to respond to the situation?

Dominik’s wellbeing

Answer 5

Important

Question 6

Sapphire has been asked to do a group presentation on sleep disorders as part of her course. In a meeting earlier in the week, she and her partner, Dominik, agreed that they would evenly distribute the work and would each present the sections that they wrote. The presentation is in an hour and Sapphire and Dominik are practising when Dominik begins to panic and tells Sapphire that he does not think he can present his sections as he is too nervous. He asks Sapphire to present his sections for him.

How important to take into account are the following considerations for Sapphire when deciding how to respond to the situation?

Whether Dominik would do the same for her.

Answer 6

This is not important at all. Acting in the best interests of others, i.e., patients, colleagues, the general public, etc., over personal interest or gain are part of the standards or principles of good practice for medical and dental professionals. Therefore, whether Dominik would do the same for her should not be an important consideration for Sapphire in this situation.

Question 7

Sapphire has been asked to do a group presentation on sleep disorders as part of her course. In a meeting earlier in the week, she and her partner, Dominik, agreed that they would evenly distribute the work and would each present the sections that they wrote. The presentation is in an hour and Sapphire and Dominik are practising when Dominik begins to panic and tells Sapphire that he does not think he can present his sections as he is too nervous. He asks Sapphire to present his sections for him.

How important to take into account are the following considerations for Sapphire when deciding how to respond to the situation?

That they had agreed to each present their own sections of the presentation

Answer 7

Minor importance
The ability to adapt to change is also considered as an important aspect of good practice across professional groups. Therefore, given the previous agreement, the division of work should be of minor importance in this scenario.

Question 8

An elderly patient with an inoperable illness has been informed by Dr Nicholson that the medical team has determined that no further treatment is available for his condition. However, the patient is convinced that further treatment would be beneficial. He has been reading about further treatment on the internet and believes this could be the right course of action for him at this time. He tells Dr Nicholson that he would like to be given further treatment for the illness, despite the medical team’s decision.

How important to take into account are the following considerations for Dr Nicholson when deciding how to respond to the situation?

That the medical team have made their decision based on their combined expertise

Answer 8

Important
Although the medical team have made a decision, it may be that the situation can be reassessed in light of the patient’s research. This is an important consideration.

Question 9

An elderly patient with an inoperable illness has been informed by Dr Nicholson that the medical team has determined that no further treatment is available for his condition. However, the patient is convinced that further treatment would be beneficial. He has been reading about further treatment on the internet and believes this could be the right course of action for him at this time. He tells Dr Nicholson that he would like to be given further treatment for the illness, despite the medical team’s decision.

How important to take into account are the following considerations for Dr Nicholson when deciding how to respond to the situation?

Maintaining a positive outlook for the patient

Answer 9

Important

Question 10

An elderly patient with an inoperable illness has been informed by Dr Nicholson that the medical team has determined that no further treatment is available for his condition. However, the patient is convinced that further treatment would be beneficial. He has been reading about further treatment on the internet and believes this could be the right course of action for him at this time. He tells Dr Nicholson that he would like to be given further treatment for the illness, despite the medical team’s decision.

How important to take into account are the following considerations for Dr Nicholson when deciding how to respond to the situation?

That the patient may not fully understand the complexities of the treatment

Answer 10

Very important

Question 11

A seven-year-old patient, Jessica, has arrived at the hospital with her mother, Germaine. After conducting an examination, Pauline, a medical student, determines that Jessica is having an asthma attack and needs an inhaler with medication to treat her asthma. After explaining this, Germaine tells Pauline that she does not “believe in medicating” her child. She tells Pauline that she prefers to use herbal remedies. It is important for Jessica to use the inhaler to prevent her asthma from getting worse.

How important to take into account are the following considerations for Pauline when deciding how to respond to the situation?

That Germaine does not believe that the medical inhaler is necessary

Answer 11

Important, but may change mind with explanation

Question 12

A seven-year-old patient, Jessica, has arrived at the hospital with her mother, Germaine. After conducting an examination, Pauline, a medical student, determines that Jessica is having an asthma attack and needs an inhaler with medication to treat her asthma. After explaining this, Germaine tells Pauline that she does not “believe in medicating” her child. She tells Pauline that she prefers to use herbal remedies. It is important for Jessica to use the inhaler to prevent her asthma from getting worse.

How important to take into account are the following considerations for Pauline when deciding how to respond to the situation?

That Germaine has a right to decide how to manage Jessica’s treatment and care

Answer 12

Very important

Question 13

A seven-year-old patient, Jessica, has arrived at the hospital with her mother, Germaine. After conducting an examination, Pauline, a medical student, determines that Jessica is having an asthma attack and needs an inhaler with medication to treat her asthma. After explaining this, Germaine tells Pauline that she does not “believe in medicating” her child. She tells Pauline that she prefers to use herbal remedies. It is important for Jessica to use the inhaler to prevent her asthma from getting worse.

How important to take into account are the following considerations for Pauline when deciding how to respond to the situation?

That Jessica is in need of medical treatment

Answer 13

Very important

Question 14

A busy clinician witnesses a receptionist in a patient waiting area trying to deal with an angry patient. The patient is shouting at the receptionist because he has been waiting for over an hour. The receptionist looks shocked by the patient’s behaviour and asks him to sit down. The patient slams his hand on the reception desk and continues shouting.

How important to take into account are the following considerations for the clinician when deciding how to respond to the situation?

The perception others will have of the hospital

Answer 14

Not at all important

Question 15

A busy clinician witnesses a receptionist in a patient waiting area trying to deal with an angry patient. The patient is shouting at the receptionist because he has been waiting for over an hour. The receptionist looks shocked by the patient’s behaviour and asks him to sit down. The patient slams his hand on the reception desk and continues shouting.

How important to take into account are the following considerations for the clinician when deciding how to respond to the situation?

The clinician’s current workload

Answer 15

Not at all important

Question 16

A busy clinician witnesses a receptionist in a patient waiting area trying to deal with an angry patient. The patient is shouting at the receptionist because he has been waiting for over an hour. The receptionist looks shocked by the patient’s behaviour and asks him to sit down. The patient slams his hand on the reception desk and continues shouting.

How important to take into account are the following considerations for the clinician when deciding how to respond to the situation?

The possibility the patient might make a complaint

Answer 16

Not at all important

Question 17

Kieran, a medical student, is supporting on the GP surgery reception desk when he is approached by a member of the Local Authority, Amalia, who is investigating the absence of a child from school. Amalia asks Kieran if the child has recently attended the GP surgery. Amalia insists on the information being shared as she explains that the investigation involves a complex family situation. Kieran is aware that under the surgery’s confidentiality policy, unless there is a court order or the parent or guardian of the child consents, he cannot reveal confidential information.

How appropriate are each of the following responses by Kieran in this situation? Assume that each of the following responses would be said politely.

“I understand that this is a sensitive situation, but I am unable to share information at this point.”

Answer 17

This is an appropriate, but not ideal thing to say because although it correctly reflects the inability to disclose or share information, it does not provide a rationale or explain the circumstances in which the request to disclose information may be granted as per the surgery’s confidentiality policy and General Data Protection Regulation (GDPR).

Question 18

Kieran, a medical student, is supporting on the GP surgery reception desk when he is approached by a member of the Local Authority, Amalia, who is investigating the absence of a child from school. Amalia asks Kieran if the child has recently attended the GP surgery. Amalia insists on the information being shared as she explains that the investigation involves a complex family situation. Kieran is aware that under the surgery’s confidentiality policy, unless there is a court order or the parent or guardian of the child consents, he cannot reveal confidential information.

How appropriate are each of the following responses by Kieran in this situation? Assume that each of the following responses would be said politely.

“I could ask someone more senior how I might be able to get that information.”

Answer 18

This is a very inappropriate thing to say because this response does not indicate to the person making the request that compliance with the request would be a breach of patient confidentiality as per the surgery’s confidentiality policy and General Data Protection Regulation (GDPR). The response also does not reflect that policies on patient confidentiality and GDPR apply to all staff at the surgery regardless of grade or seniority.

Question 19

Finnley, a medical student, is on placement on the oncology ward. He is asked by a nurse to find Dr Orlaith, a junior doctor, as one of the nurse’s patients is in a lot of pain and very distressed. The nurse tells Finnley that she has attempted to contact Dr Orlaith several times but has not received a response. Finnley finds Dr Orlaith in the staff room on her lunch break. When Finnley asks Dr Orlaith if she can respond to her pager, she tells Finnley that she is hungry and tired, and that she will see to the patient when she has finished her lunch.

How appropriate are each of the following responses by Finnley in this situation? Assume that each of the following responses would be said politely.

“Please can you advise if there is anything we can be doing to help the patient?”

Answer 19

This is an appropriate, but not ideal thing to say because although it may prompt the junior doctor to attend to the patient, it does not reflect that the junior doctor is primarily responsible for that patient. They not only have a duty to provide a good standard of care but they are required to work with colleagues in ways that best serves the interest of their patient. By not responding to their patient’s needs and the attempts to draw their attention to it, the junior doctor is not only being unprofessional but is potentially neglecting their duty.

Question 20

Finnley, a medical student, is on placement on the oncology ward. He is asked by a nurse to find Dr Orlaith, a junior doctor, as one of the nurse’s patients is in a lot of pain and very distressed. The nurse tells Finnley that she has attempted to contact Dr Orlaith several times but has not received a response. Finnley finds Dr Orlaith in the staff room on her lunch break. When Finnley asks Dr Orlaith if she can respond to her pager, she tells Finnley that she is hungry and tired, and that she will see to the patient when she has finished her lunch.

How appropriate are each of the following responses by Finnley in this situation? Assume that each of the following responses would be said politely.

“It is not fair to the nurses to ignore them.”

Answer 20

Inappropriate, but not awfu

Question 21

Finnley, a medical student, is on placement on the oncology ward. He is asked by a nurse to find Dr Orlaith, a junior doctor, as one of the nurse’s patients is in a lot of pain and very distressed. The nurse tells Finnley that she has attempted to contact Dr Orlaith several times but has not received a response. Finnley finds Dr Orlaith in the staff room on her lunch break. When Finnley asks Dr Orlaith if she can respond to her pager, she tells Finnley that she is hungry and tired, and that she will see to the patient when she has finished her lunch.

How appropriate are each of the following responses by Finnley in this situation? Assume that each of the following responses would be said politely.

“I am sure that the nurses are tired as well, but they are still working.”

Answer 21

This response is a very inappropriate thing to say because it could be perceived as being unprofessional and/or disrespectful to a senior colleague, it does not take into consideration the junior doctor’s perspective or wellbeing. This type of approach does not foster a culture of collaborative working and fostering a compassionate, supportive and fair working environment.

Question 22

Ria and Nathan are students who attend the same placements. Nathan has chronic back pain that sometimes makes it difficult for him to work. The school has agreed that Nathan can advise the school if his pain is too bad and they will then help him to rearrange his placement. Last week, Nathan did not attend a scheduled placement, and he did not call the school to let them know until afterwards. The school told him that he would fail his placement as a result. Nathan feels that this is unfair and complains to Ria.

How appropriate are each of the following responses by Ria in this situation? Assume that each of the following responses would be said politely.

“You can’t be too upset because you did not follow the rules.”

Answer 22

This is an inappropriate, but not awful thing to say as Ria is highlighting Nathan’s responsibility for his own actions. This is particularly significant in this case because attendance is a vital aspect of professionalism which is an important behaviour to demonstrate as a student on placement as it is a General Medical Council (GMC) and General Dental Council (GDC) requirement. Professionalism also links in with personal and professional values such as being reliable, being trustworthy and good communication, which are essential in the medical/dental professions.

However, this response is not appropriate as Ria is a fellow student and it is not a a kind or compassionate thing to say, nor is it her place to judge Nathan, particularly as he has a pre-existing health condition which may have contributed to the situation. It is important that health professionals, including trainees, practice a non-judgemental approach.

Question 23

Ria and Nathan are students who attend the same placements. Nathan has chronic back pain that sometimes makes it difficult for him to work. The school has agreed that Nathan can advise the school if his pain is too bad and they will then help him to rearrange his placement. Last week, Nathan did not attend a scheduled placement, and he did not call the school to let them know until afterwards. The school told him that he would fail his placement as a result. Nathan feels that this is unfair and complains to Ria.

How appropriate are each of the following responses by Ria in this situation? Assume that each of the following responses would be said politely.

“It must be hard to manage your schedule when you are in pain.”

Answer 23

This is a very appropriate thing to say because it demonstrates understanding of the impact of pain on an individual, compassion and empathy for Nathan’s situation, which are all essential values and traits within the medical and dental professions.

Question 24

Ria and Nathan are students who attend the same placements. Nathan has chronic back pain that sometimes makes it difficult for him to work. The school has agreed that Nathan can advise the school if his pain is too bad and they will then help him to rearrange his placement. Last week, Nathan did not attend a scheduled placement, and he did not call the school to let them know until afterwards. The school told him that he would fail his placement as a result. Nathan feels that this is unfair and complains to Ria.

How appropriate are each of the following responses by Ria in this situation? Assume that each of the following responses would be said politely.

“I think it is completely unfair that they would fail you for missing just one day.”

Answer 24

This is a very inappropriate thing to say because it suggests acting professionally and following the rules are not important. Professional rules and guidelines are in place for a reason and are integral for the maintenance of staff and patient safety in healthcare. Adherence to policy and guidelines is a professional requirement in the medical profession and is linked to professionalism, behaviour and conduct.

Question 25

Bruntha and Leanne, two medical students, are waiting with the rest of their class to enter the anatomy room for their first dissection lesson. Medical students must attend all dissection lessons in order to progress in their studies. Bruntha mentioned to Leanne earlier in the day how nervous she was feeling about seeing human flesh. Bruntha is now panicking and tells Leanne that she feels very unwell and faint and does not want to enter the room.

How appropriate are each of the following responses by Leanne in this situation?

Try to persuade Bruntha to enter the anatomy room so she can speak to the anatomy lecturer herself about the fact that she is feeling unwell

Answer 25

Very appropriate

Question 25

Arnold, a medical student, is completing a placement in a local hospital and is observing a consultant, Dr Macham, complete a ward round. Dr Macham is talking to a patient whilst writing him a prescription for an antibiotic, which a nurse will then administer. Dr Macham then receives an urgent request and leaves the ward. Arnold reviews the notes and realises that the patient is allergic to the antibiotic prescribed by Dr Macham.

How appropriate are each of the following responses by Arnold in this situation?

Inform another doctor on the ward about his concerns regarding Dr Macham’s prescription

Answer 25

Very Appropriate

Question 26

Arnold, a medical student, is completing a placement in a local hospital and is observing a consultant, Dr Macham, complete a ward round. Dr Macham is talking to a patient whilst writing him a prescription for an antibiotic, which a nurse will then administer. Dr Macham then receives an urgent request and leaves the ward. Arnold reviews the notes and realises that the patient is allergic to the antibiotic prescribed by Dr Macham.

How appropriate are each of the following responses by Arnold in this situation?

Ask the patient to confirm if he is allergic to any medicines

Answer 26

Very appropriate

Question 26

A student, Aaron, is speaking to a friend on his course, Lei. Aaron tells Lei that he has been given negative feedback from a clinician about his interpersonal skills, particularly his interactions with patients. He thinks that the feedback is unfair and he is clearly upset.

How appropriate are each of the following responses by Lei in this situation?

Advise Aaron to ask other students whether they have received negative feedback from this clinician

Answer 26

This may seem like a reasonable thing to do, but Aaron must remember that receiving negative feedback is part of the normal feedback process. No-one will be satisfactory all of the time, whilst training. The feedback that others have been given is therefore irrelevant. This is not an awful course of action, but it is inappropriate.

Question 27

A dentist is undertaking a routine check up on a 10 year old boy. During the check up the boy starts crying violently and screams that he wants to go home.

How appropriate are each of the following responses by the dentist in this situation?

Suggest that the mother book another appointment at a later date

Answer 27

Although booking an appointment at a later date is likely to be very appropriate due to the boy being upset and the likely subsequent effects on treatment outcome, there should also be a preceding definite attempt to calm the boy. For this reason, suggesting that the appointment be rescheduled is, in isolation, only an appropriate thing to do.

Question 28

A student, Aaron, is speaking to a friend on his course, Lei. Aaron tells Lei that he has been given negative feedback from a clinician about his interpersonal skills, particularly his interactions with patients. He thinks that the feedback is unfair and he is clearly upset.

How appropriate are each of the following responses by Lei in this situation?

Advise Aaron that many students receive unfair feedback and that the feedback will balance out over time

Answer 28

Receiving negative feedback is normal and part of the feedback process. It is not necessarily unfair. He must learn to accept this feedback and change his practice for the better. As such, this response is inappropriate, but not an awful thing to do.

Question 29

Levi is a medical student and is observing a doctor who is seeing patients at a clinic in the hospital. The patients have pre-booked appointments, but the clinic is running 30 minutes behind schedule due to staff shortages. Levi leaves the private consulting room to collect some paperwork that the doctor needs for the current consultation. Whilst passing through the patient waiting area, a patient approaches Levi and complains in a raised voice about the waiting time. She demands to be seen next.

How appropriate are each of the following responses by Levi in this situation?

Tell the patient to calm down and agree that the doctor will see her next

Answer 29

This is very inappropriate for two reasons. One is that simply telling a patient (or staff member or anyone else for that matter!) to ‘calm down’ is likely to have the opposite effect and escalate the tension. Levi has not taken time to understand the patient’s specific concerns and address them. Secondly, it is not the right approach to simply promise the patient they can be seen next. From the stem we do not know if there is any valid reason why this patient might be seen in front of other patients who have been waiting as long, and promising a patient something that you may not be able to go through with is likely to exacerbate the situation.

Question 30

Levi is a medical student and is observing a doctor who is seeing patients at a clinic in the hospital. The patients have pre-booked appointments, but the clinic is running 30 minutes behind schedule due to staff shortages. Levi leaves the private consulting room to collect some paperwork that the doctor needs for the current consultation. Whilst passing through the patient waiting area, a patient approaches Levi and complains in a raised voice about the waiting time. She demands to be seen next.

How appropriate are each of the following responses by Levi in this situation?

Try to find out if there is anything that can be done about the waiting time

Answer 30

Although this is appropriate in that Levi is trying to gather more information or attempt to find practical solutions for the waiting time, it is not the ideal approach. Levi has been sat in with the doctor seeing patients, so knows that the doctor likely can’t go any faster. Also Levi has been sent to find some notes for the current patient, so by getting distracted and spending a long time seeing what, if anything, can be done about waiting time he is actually slowing down the current appointment and thus increasing the wait time further.

Question 31

Simon, a junior dentist, is conducting a dental procedure on a patient using local anaesthesia. During the procedure, his hand slips and he accidentally stabs the patient’s bottom lip with the dental instrument. Simon cannot see any cuts or signs of bleeding around the patient’s mouth area. As the patient’s mouth is numb, Simon’s accident seems to have gone unnoticed. Simon is aware that policy guidelines state that patients and supervisors must be informed of all accidents.

How appropriate are each of the following responses by Simon in this situation?

Say nothing and await to see if the patient makes a comment

Answer 31

Saying nothing would go against the policy guidelines, and so this would be a very inappropriate course of action. It may also be the case that the patient cannot report any painful consequences until the anaesthetic has worn off, at which point they will probably already have been discharged to go home.

Question 32

Simon, a junior dentist, is conducting a dental procedure on a patient using local anaesthesia. During the procedure, his hand slips and he accidentally stabs the patient’s bottom lip with the dental instrument. Simon cannot see any cuts or signs of bleeding around the patient’s mouth area. As the patient’s mouth is numb, Simon’s accident seems to have gone unnoticed. Simon is aware that policy guidelines state that patients and supervisors must be informed of all accidents.

How appropriate are each of the following responses by Simon in this situation?

Ask the patient if she is experiencing any discomfort

Answer 32

Asking the patient if they are feeling any discomfort is a very appropriate course of action. Whilst Simon is expecting that the lip is numb from the anaesthetic, the patient may still be able to report signs of discomfort, indicating either that the anaesthetic is becoming ineffective, or there are signs of more serious damage.

Question 33

Simon, a junior dentist, is conducting a dental procedure on a patient using local anaesthesia. During the procedure, his hand slips and he accidentally stabs the patient’s bottom lip with the dental instrument. Simon cannot see any cuts or signs of bleeding around the patient’s mouth area. As the patient’s mouth is numb, Simon’s accident seems to have gone unnoticed. Simon is aware that policy guidelines state that patients and supervisors must be informed of all accidents.

How appropriate are each of the following responses by Simon in this situation?

Inform the patient about the mistake and explain there seems to be no visible harm caused

Answer 33

Very appropriate

Question 34

Cillian is a dental student on placement at a dental surgery. Dr Rae is in the consulting room to perform a minor procedure on a 12 year old patient. The patient’s mother, Haniya, has attended to provide support and is in the consulting room waiting to observe the minor procedure. During the consent process, Dr Rae asks Haniya if it is OK for Cillian to assist him with the procedure. However, Haniya expresses concern over Cillian’s competency and lack of experience. Cillian has never had the opportunity to assist with this particular procedure and does not want to miss out on such a valuable learning experience, but he does not want to upset Haniya.

How appropriate are each of the following responses by Cillian in this situation?

Ask Haniya if there is anything that he can do to reassure her

Answer 34

This is an appropriate but not ideal response. Although it appears to be reasonable for Cillian to ask what he can do to assure her, when considered in the context of the four pillars of medical ethics (beneficence, non-maleficence, autonomy and justice), the lack of an altruistic agenda with the best interest of the patient and their family is evident. Dental professionals must put patients’ interests first.

Question 35

Cillian is a dental student on placement at a dental surgery. Dr Rae is in the consulting room to perform a minor procedure on a 12 year old patient. The patient’s mother, Haniya, has attended to provide support and is in the consulting room waiting to observe the minor procedure. During the consent process, Dr Rae asks Haniya if it is OK for Cillian to assist him with the procedure. However, Haniya expresses concern over Cillian’s competency and lack of experience. Cillian has never had the opportunity to assist with this particular procedure and does not want to miss out on such a valuable learning experience, but he does not want to upset Haniya.

How appropriate are each of the following responses by Cillian in this situation?

Ask Dr Rae to reassure Haniya regarding her concerns

Answer 35

It is appropriate but not ideal for Cillian to ask Dr Rae to reassure Haniya regarding her concerns. Although it may appear reasonable to provide reassurance about Cillian’s ability to assist in the procedure, it is important to consider the impact of this on Haniya and her child. It is also important that Dr Rae’s response or actions cannot be interpreted as an attempt to undermine or ignore Haniya’s concerns, especially as Cillian is an inexperienced dental student when it comes to this particular procedure, therefore making Haniya’s concerns valid. Patients should be listened to and have their preferences and concerns considered. It is also important to note that all dental professionals must put patients’ interests before their own or those of any colleague. Therefore, Cillian’s need to take part in this potential learning opportunity must be considered secondary to Haniya’s concern about his involvement in the procedure.

Question 36

Cillian is a dental student on placement at a dental surgery. Dr Rae is in the consulting room to perform a minor procedure on a 12 year old patient. The patient’s mother, Haniya, has attended to provide support and is in the consulting room waiting to observe the minor procedure. During the consent process, Dr Rae asks Haniya if it is OK for Cillian to assist him with the procedure. However, Haniya expresses concern over Cillian’s competency and lack of experience. Cillian has never had the opportunity to assist with this particular procedure and does not want to miss out on such a valuable learning experience, but he does not want to upset Haniya.

How appropriate are each of the following responses by Cillian in this situation?

Ask Haniya if she would prefer someone else to assist with the procedure

Answer 36

Very appropriate

Question 37

Cillian is a dental student on placement at a dental surgery. Dr Rae is in the consulting room to perform a minor procedure on a 12 year old patient. The patient’s mother, Haniya, has attended to provide support and is in the consulting room waiting to observe the minor procedure. During the consent process, Dr Rae asks Haniya if it is OK for Cillian to assist him with the procedure. However, Haniya expresses concern over Cillian’s competency and lack of experience. Cillian has never had the opportunity to assist with this particular procedure and does not want to miss out on such a valuable learning experience, but he does not want to upset Haniya.

How appropriate are each of the following responses by Cillian in this situation?

Ask the patient if they are comfortable with him assisting with the procedure

Answer 37

This is a very inappropriate thing to do. It is very inappropriate for Cillian to ask the patient if he is comfortable with him completing the procedure because he is overstepping his professional boundaries as a trainee dental professional to go against the expressed wishes of Haniya as a parent.

Question 38

Cillian is a dental student on placement at a dental surgery. Dr Rae is in the consulting room to perform a minor procedure on a 12 year old patient. The patient’s mother, Haniya, has attended to provide support and is in the consulting room waiting to observe the minor procedure. During the consent process, Dr Rae asks Haniya if it is OK for Cillian to assist him with the procedure. However, Haniya expresses concern over Cillian’s competency and lack of experience. Cillian has never had the opportunity to assist with this particular procedure and does not want to miss out on such a valuable learning experience, but he does not want to upset Haniya.

How appropriate are each of the following responses by Cillian in this situation?

Explain to Haniya that this is a valuable learning opportunity for him

Answer 38

It is appropriate but not ideal to explain to Haniya that this is a valuable learning opportunity for him. Although it may seem reasonable to explain the value of the learning opportunity for a dental student, such a response or action is potentially putting Cillian’s interests above the best interest of the patient and their parent.

Question 39

A medical student, Gemma, is observing a patient consultation conducted by Dr Mitchell. Dr Mitchell is updating the patient’s medical records on the computer. He asks the patient whether he is allergic to penicillin, to which the patient replies “Yes”. However, Gemma notices that Dr Mitchell types “No” as the response to this question on the computer record.

How appropriate are each of the following responses by Gemma in this situation?

Ask the patient to repeat his answer to the question

Answer 39

This is a reasonable course of action, and may serve to clarify the patient’s response. However, it may also affect the patient/doctor relationship and so waiting to discuss it with Dr Mitchell afterwards is preferable.

Question 40

A medical student, Gemma, is observing a patient consultation conducted by Dr Mitchell. Dr Mitchell is updating the patient’s medical records on the computer. He asks the patient whether he is allergic to penicillin, to which the patient replies “Yes”. However, Gemma notices that Dr Mitchell types “No” as the response to this question on the computer record.

How appropriate are each of the following responses by Gemma in this situation?

Inform the patient privately about the error after the consultation has finished

Answer 40

This is an inappropriate course of action. Without seeking further clarification from Dr Mitchell, Gemma is not making an informed judgement, and this may be detrimental to the doctor/patient relationship.

Question 41

A dental student, Rio, is leading a group of fellow students in a project they have been assigned to work on together. Jerome approaches Rio with a complaint about one of the other students in the group, Elizabeth. Jerome insists that Elizabeth is not dedicating enough time and effort to the group project. Jerome explains that Elizabeth leaves meetings early and her notes are not very comprehensive when she is asked to research topics. He asks if Rio can do something about this as he is the leader of the group.

How appropriate are each of the following responses by Rio in this situation?

Report Elizabeth’s lack of dedication to the academic tutor

Answer 41

This option is inappropriate, as Rio should be managing the situation and this matter does not, at this stage, involve the academic tutor. No attempt has been made at resolution. This course of action does not have severe consequences.

Question 42

A dental student, Rio, is leading a group of fellow students in a project they have been assigned to work on together. Jerome approaches Rio with a complaint about one of the other students in the group, Elizabeth. Jerome insists that Elizabeth is not dedicating enough time and effort to the group project. Jerome explains that Elizabeth leaves meetings early and her notes are not very comprehensive when she is asked to research topics. He asks if Rio can do something about this as he is the leader of the group.

How appropriate are each of the following responses by Rio in this situation?

Ask other members of the project group whether they have similar concerns about Elizabeth’s behaviour

Answer 42

Very appropriate

Question 43

Daniella, a medical student, is currently on placement in the emergency department. She is about to escort her next patient, who presents with a sprained ankle, into the consulting room. She then notices a young boy, about three years old, crying out for his mother. It is clear that he is lost and scared. His mother is not in sight.

How appropriate are each of the following responses by Daniella in this situation?

Inform the patient with the sprained ankle that she will return to him as soon as possible, after she has assisted the lost boy

Answer 43

The patient with the sprained ankle is not in any immediate danger. Whilst it might be a mild inconvenience, asking the patient politely to wait whilst the lost boy’s mother is found is an entirely appropriate course of action.

Question 44

Daniella, a medical student, is currently on placement in the emergency department. She is about to escort her next patient, who presents with a sprained ankle, into the consulting room. She then notices a young boy, about three years old, crying out for his mother. It is clear that he is lost and scared. His mother is not in sight.

How appropriate are each of the following responses by Daniella in this situation?

Ask the receptionist to deal with the lost boy so that Daniella can tend to the patient with the sprained ankle

Answer 44

Asking the receptionist means that Daniella can continue her work. However, this isn’t the receptionist’s responsibility and it will mean that in turn the receptionist is unable to pay full attention to their duties. Whilst not awful, this isn’t an appropriate course of action.

Question 45

Daniella, a medical student, is currently on placement in the emergency department. She is about to escort her next patient, who presents with a sprained ankle, into the consulting room. She then notices a young boy, about three years old, crying out for his mother. It is clear that he is lost and scared. His mother is not in sight.

How appropriate are each of the following responses by Daniella in this situation?

Ask the patients in the waiting room if they have seen the boy’s mother

Answer 45

Whilst asking the patients in the waiting room if they have seen the boy’s mother would be a useful way of finding out where she has gone, it would be more appropriate to first comfort and reassure the upset boy.

Question 46

Daniella, a medical student, is currently on placement in the emergency department. She is about to escort her next patient, who presents with a sprained ankle, into the consulting room. She then notices a young boy, about three years old, crying out for his mother. It is clear that he is lost and scared. His mother is not in sight.

How appropriate are each of the following responses by Daniella in this situation?

Distract the boy with toys and escort him to the play area, then return to tend to the patient with the sprained ankle

Answer 46

Whilst distracting the boy may take his mind off losing his mother, this doesn’t attempt to resolve the situation. Further, leaving to deal with the sprained ankle means that Daniella is unable to monitor the boy’s situation and try and find his mother. This is a very inappropriate course of action.

Question 47

Taylah is a dental student on placement in a dental practice. She offers to watch the reception area for 5 minutes while the receptionist, Dan, reparks his car. Dan has been working at the practice for 6 weeks. Taylah uses the computer on the reception desk to check her shifts for next week and sees an open webpage displaying receptionist job roles in other practices. The computer is only usually used by Dan. It is against practice policies to use work computers for personal reasons.

How appropriate are each of the following responses by Taylah in this situation?

Inform the practice manager of what she has found on the computer

Answer 47

This is an appropriate thing to do (but not ideal) because the practice should be made aware if Dan is looking for other roles or misusing his computer. However, it may be more appropriate for Taylah to speak with Dan about it first, to ask him if he wants to discuss how he is feeling at work, and to ensure that he speaks to the practice manager.

Question 48

Taylah is a dental student on placement in a dental practice. She offers to watch the reception area for 5 minutes while the receptionist, Dan, reparks his car. Dan has been working at the practice for 6 weeks. Taylah uses the computer on the reception desk to check her shifts for next week and sees an open webpage displaying receptionist job roles in other practices. The computer is only usually used by Dan. It is against practice policies to use work computers for personal reasons.

How appropriate are each of the following responses by Taylah in this situation?

Ask Dan if he is looking for other jobs, without referencing what she has found

Answer 48

Although not highly inappropriate because it would be unlikely to make the situation worse, this is inappropriate because it would be better to be straightforward with Dan, so that she can ensure that together they proceed in doing the right thing.